Psychiatry and Clinical Neuroscience

A Primer

Charles Zorumski and Eugene Rubin

first book to examine how advances in network neuroscience are likely to impact the diagnosis and treatment of psychiatric disorders

reflects an upcoming revolution in the field that has tremendous potential for improving the care of patients with these devastating illnesses

Psychiatry and Clinical Neuroscience

A Primer

Charles Zorumski and Eugene Rubin

Description

Research in neuroscience is revolutionizing how we think about psychiatric diagnosis and treatment. Psychiatric disorders reflect dysfunction of the human mind and involve changes in cognition, emotion, and motivation. Understanding how the neural networks that underlie these mental functions become dysfunctional holds great promise for devising innovative approaches to diagnosis and treatment. Scientific progress is being driven, in part, by advances in human functional neuroimaging, which is being used to characterize the activity of specific brain circuits at rest and during the performance of specific tasks. Moreover, advances in clinical neuroscience are being coupled with expanding knowledge about genetics and cellular and synaptic neuroscience. Taken together, these advancements offer the hope of much more mechanism-based approaches to treatment in the future. Better understanding of neural circuits also can provide the basis for innovative psychotherapeutic strategies that take advantage of brain plasticity for purposes of neurorehabilitation. In this book, we examine recent developments in the field of network neuroscience and their potential impact on clinical psychiatry, including the way that psychiatrists are trained and interact with other medical specialties and mental health professionals.

Psychiatry and Clinical Neuroscience

A Primer

Charles Zorumski and Eugene Rubin

Table of Contents

Table of Contents 1. Psychopathology 101a. Mental status examinationb. The nature of psychiatric symptoms: insights from behavioral neurologyc. Cognitive symptoms: psychotic and non-psychotic thinkingd. Disturbances in the form of thoughte. Disturbances in emotionsf. Disturbances in motivation: the role of salience and personalityg. Disturbances in memory h. Points to remember

4. Brain Networks and the Human Minda. Cognition (Thinking)i. Working memory & prefrontal cortex (PFC)ii. How does the brain select thought content?iii. PFC does more than working memoryiv. PFC and neuropsychiatric disordersv. Perception is cognitively complexvi. Lateralized brain function & cognitionvii. Intelligence and cognitive flexibilityb. Emotions: computing values & meaning i. What values, what meaning?ii. How are emotions processed?iii. Other emotions & other brain regionsiv. What triggers emotional responses in the brain?c. Motivation: the importance of having goalsi. How does motivation work?ii. What determines our expectations?d. Summary: a simplified overview of brain systems and minde. Points to remember

6. The Hippocampus: Synapses, Circuits, and Networksa. Why is the hippocampus important?b. What is the hippocampus?c. How does information flow within the hippocampal system?d. What do hippocampal subregions do?e. Synaptic plasticity: how the hippocampus learnsf. The hippocampus does not act aloneg. Sleep and the hippocampush. Neurogenesis (new neurons) and the hippocampusi. Information flow: a reprisej. Points to remember

7. Network Dysfunction: Stress, Psychiatric Disorders and the Hippocampusa. Psychiatric disorders and structural changes in the hippocampusb. Causes of hippocampal changes in psychiatric illnessesc. The stressed hippocampus: lessons from animal modelsd. Recent human studies in mood and psychotic disorderse. Can defects in connectivity be corrected? Potential therapeutic targetsf. What about other brain regions and networks?g. Points to remember

10. Neurotransmitters and Receptorsa. Neurotransmitters and receptorsi. The brain uses a variety of neurotransmittersii. Transmitters use a variety of receptorsb. Neurotransmitters and synapses: complex signaling devicesc. Transmitters, synapses, and brain rhythmsd. Why antidepressants take time to work while benzodiazepine anxiolytics act quicklye. Points to remember

11. Methods of Determining Diagnosis and Causea. Current methods of diagnosisb. Current use of laboratory and imaging proceduresc. Current use of psychological testingd. Future approaches to diagnosise. Future trends related to psychiatric diagnosesf. Points to remember

12. Why Do Some Psychiatric Disorders Become Chronic Problems?a. Problems with current treatments and practiceb. Brain mechanisms contributing to refractory illnessesc. Connectivity networks, brain mechanisms and refractory disordersi. Anosognosiaii. Anergiaiii. Amotivationiv. Aplasticityv. Asocialityd. How can psychiatry take advantage of synaptic plasticity?i. The brain needs to learnii. The brain needs noveltyiii. Social interactions are importantiv. Lifestyle can have huge and non-linear effects on outcomese. Points to remember

Psychiatry and Clinical Neuroscience

A Primer

Charles Zorumski and Eugene Rubin

Author Information

Dr. Zorumski is the Samuel B. Guze Professor and Head of the Department of Psychiatry and Professor of Neurobiology at Washington University in St. Louis - School of Medicine, where he is also Psychiatrist-in-Chief at Barnes-Jewish Hospital and Director of the McDonnell Center for Cellular and Molecular Neurobiology. His research focuses on synaptic transmission in the hippocampus, and on the use of brain stimulation methods to treat psychiatric disorders.

Dr. Rubin is Vice-Chair for Education and Professor in the Department of Psychiatry at Washington University in St. Louis - School of Medicine. He is also Professor of Psychology at Washington University in St. Louis. His research interests include Alzheimer's disease and depression in the presence of comorbid medical illness. He directed the psychiatry residency training program at Washington University School of Medicine for 20 years.

Psychiatry and Clinical Neuroscience

A Primer

Charles Zorumski and Eugene Rubin

Reviews and Awards

"Zorumski and Rubin have written a delightful volume proposing a new and intriguing theory regarding the pathogenesis of mental disorders... It certainly presents an impressive summary of research into brain function and structure compiled thus far and discusses areas of future research. Additionally, I think Psychiatry and Clinical Neuroscience should be a must-read for psychiatric residents and those clinicians who want to peek into the future. I found the arguments compelling and was excited to read this book!" - David L. Dunner, MD, Journal of Clinical Psychiatry

"...here the authors' enthusiasm for network neuroscience, their impatience with outdated modes of psychiatric practice, and their excitement for the future of psychiatry come into their own. The enthusiasm is especially palpable throughout the book and one hopes it will prove infectious for the intended audience. Indeed should the book be successful in luring future clinician-scientists into the profession, it would have undoubtedly achieved some of its most important aims." -- Mikail Rubinov, Psychological Medicine